Loading...
HomeMy WebLinkAbout12063 '----. , ----��--- C1TY OF DIAMOND BAR � - �' COMMUNITY DEVELOPMENT DEPARTMENT r zi66o s.coPtey D�y�s��ce�90 . . PRESS � (909)860-3195 Fax(909)861-3117 . . "^' BUILDIIIG PERMIT APPLICATION FIRM LY � JOBSITE �g� /�/�/�/� ��J �r /it1 e.1�j�� � ' APPLICATION'� � PERMIT � �/C • � o ADDRESS '�/'�j I'�[J/`'����`^✓ L�T�IJ v'�� DATE - ' NUMBER c� � ISSUE 7YPE OCC ., ' � APN LOT TRACT - '"' DATE ' '- 'CONST. - GROUP p OWNER _ � ADDRESS 1 ZONING SETBACKS �w FRONT-. _. . RW ._.� O .. . .. Z CITY + • ZIP �6 TEL. REAR O : o APPLICANT - . � ' SIDEJSIDE STREET RW ❑ � CONTRACTOR GL� - SIDE' - . _._.. -p , , , ADDRESS 1 ac _ _._ p - PROPOSED USE � � _ CITY ` � • ZIP TEL. / .. _ ` o ARCH/ENG/ . _ _ _ _ . _ � . . � - , W DESIGNER , NO.OWEL. NO. _, NO. . _ a ADDRESS UNITS STORIES BEDROOMS ' = CITY ZIP TEL - � _ - • -- - . _. _. _ _ �. . � �ESCRIP710N SQ.FT FACTOR PSF " ' ADJ.AREANALUATION ; � � -�-�OWNER-Bl.7LDER DECLARATION - _. . - : '� gFR/ADDlREM - � � � . - ._ . ._. . . _.. _ �_.. . . � O . _. ___ --p .I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT I11M ExEMPT FROM THE CONTW�CTORS U-� � Ga[8g01CdryOR - �- � � � � � ' W CENSEUWFORTHEFOLLOWINQNEASOf!(SEC.7071.SBUSINESSANDVROFESSIONSCODE:AM'GITYOfl , (fj ' ' U �p�ryiyWMICMPEOUIRESAPERMITTOCONSTRUCT,AITER�PROVE�DEMOLISH.ORREPAIRANYSTRUC- : W PaIlO/DBCI( "' ' ' � � WTUFE.PRIOH TO RS ISSUANCE,ASO REOUIilES THE APPUCUJT FOR SUpI PE�IT TO FILE A SIGNED � W - - � � STAiE�ENT THA7 HE OF SHE IS UCENSE�PUFSUAN7 TO TNE PNOVISIONS OF TNE LONTiiACTORS LF . . , � �CENSEUW�CNAPTER9�MMENCWOYATMSECTION7000�OFDIVISWNJOFTMEBUSINESSANDPFO� � PooVSpa -'� �� � � FESSIONSCODE)ORTI�ATHEOPSHEISE7fEMPT7HEREFROMIWOTHEB��SFORTHEALLEGEDE%EMP-� , , . V TION.ANYVIOU7IONOFSECTION7o71.S8YANYAPVLICANTFORACERM175UeJECTSTMEAPPLiCANTTO '• Z Re-Root � � ACMLDENALTYOFNOTIAORETHANFIVEMUNOREDDOLUR5�f50o).): , � pl,�SOWNEROFiHEPROPERT:ORMYEMPLOVEESYnTMWACE5A5iHEIR30lECOMPENSATION,�, '�. C] C01BT6fClal � � Z 1MLL DO T11E WORK�ND TME 9TRUCTURE IS NO7IMENDED OR OFFERED FOR 6QE(SEC.7oN.BU51- J ' NE55 AND PROFESSIONS CODE:THE CONTRACTORS UCENSE LAW DOES NOT APPLYTO AN OwNER OF �� - . � VROPERTYVA/OBURASOPII.IPROYE57HEREON.ANDN'MODOESSUCHWORKMIMSELFORNERSELiOR , � � (L THROUGMMISORMEROWNEMPLOYEES.PROVIDEDTMATSUCMIMPROYEkENTSMENOTINTENDE00R , w OfFEREDFOi15ILE�F,F10H'EVERTMEBUILDINGORIMPROVEAIEMISSOIDN�THINONEYFAROFC061PLE-- � ���� � � ' , z 'TION,7HE OWNER-BUILDER WILL HAVE THE BUR�EN OF PqOVING THAT NE OR SME OID NOT BVILO OR . _ . � MPROVEFORTMEPUHPOSEOFSA�EJ. - � � � � �� �"' � - OI,ASOWNEHOFiHEGROFERT'l,AME%LLUSIYEIYCOMMCTWGVATMLICENSEDCONTFUCTORS_ �� . . _ , ,. _ _. . . ._. -. ._. __... _ _ . W CENSENUWDOESNOTAPGLYTOSANOYN�EROF'APRO�RT1'WFqBUtLDSORwPnov�inEaeon.uio � Valuatlon � ADJ.AREA " - r a1s���ceNseovuaswwr7oinetorirw�o. `�, -pUANTITY� DESCRIPTION � �- --�-- --� �- FEE :.- - -� S WHpCOMRACiSFORSUCMDROJECfSWITHACONTMCfO N� TORSUGENSEUW). ' " "' - ' � � ,. Y . . ... �. . _.. . : _ '. . .... ._ . .. _. .. .r � .___ _ _. _ . . , ! � OIAMEXE47iUNDERSEC. 8.8P.C.FORTNISREASON � - .. � _ _ '_ "_ _ . . ' . V .... . . ' . . ' _. . _. ._._ . � ..... . __ .. . . __ _ . u" OATE OWNER . , .. . _ U . . � , . .. .. .. .. . O . W .. .. . ... . .... __. . .. ' _ '' ' . _ h, __.. .. -- UCENSED CONTRACTORS DECLARATION . . ' - ' -� ' ' - - a,� ; . - w . IMEREBYAFFIRMUN�ERPENAITYOFVERIURYTHATIAMLICENSEOUNDERPRONSbNSOFCWWTER � f . ♦ � � d i(COMMENCINO WITH SECTION 7000)OF DNISION 70F THE BUSINESSAND PROFESSIONS CODE,MD Z X IAY LICENSE IS N FULL FORC/f A?ND EF/FfC�T. •� �7 ` m � ' , � . _ .- --`/�l0 LIC.NO. /� J�� 7� � _ , __ ,_--� . �- . . �� ;.� � LICENSE CLASS � :.7�.^a� (_ e� . __ � .� . DATE CONTMCTOR W . � WOFKERS'COMPENSATION DECLARATION -� = U � N IHEREBVAFFlRMUNDERPENALNOFPERIURVONEOFTHEFOLLOYlINGOECLAAA7qN5: � . . N Z . _ . Q . . _ . . _ . . . . � Q �IHAVEMIDVALLM/UNTAINACERiIFICATEOFGONSENTTOSELFdNSUREFORWORKERS' _ � --� ; � C0IAFEN54TION.AS�ROVIOEDBYSECTION77000Fi11ElABORG00E.FORTHEVEFFOR�.�ANCE w _ THEWORKFORWFIIpiTNISPERMI715155UEU. _ _ , . � .. _W ' "' .. . . . .. _I HAVE AND WILL MAINTAIN WOfUCERS'CAMPENSATION INSUPANCE,AS RE W IRED BV SEMION � Q 970o OF THE LABOR CODE.FORTNE PERFORMANCE OF THE WOPI(FOR W WCH TMIS OERMIT 1$ � ISSUED.MY WORKERS'COMPENSATION IMSUHANCE CARRIER ANO PQI.iCV NUMBER ME' - CONSTRUCTION - - ' - - - ' - Q ��. 1 ��r_ 7 CAFRiEfl� /V L�= PLAN REVIEW . .._ .. . ._ . .. ." ' . _ .'_'. . .""'._.' _'_. . .___ . .._..__._ . . . - � POIICYNUMBER � , ' ELECTRIC { Q . �l� �� - �(MSSECIIONNEmNOiBENMttETmOFT£GEPoXTSPoiIONEHIkL%7EDOQ1AiLS�if00)ORLE:S� PLUMBING . . � Z 1 CERTIFV THAi W THE PERFORMMlCE OF THE WORK FOq WHICM iHiS PEFA�IT IS�SUE0.1 MECHANICAL -(} _ -SFIALLNOT EMPLOYANV iEfiSON IN ANY AIANNER 50AS TO BECAMc SUBJEC7 TO TNE N WORNERS'f.CMPEN5A7qNlAW50FGWFORNIA,ANDAGREETMATIF15MOUlDBECOME INSPECTIONFEE �"� �- -�' '-"' ' '-' '" " S SUBJECT TOME WORKERS'COMPENSATqN PROVISION9 OF SECT�ON 77o00F THE UBOfl �1 CADE,I SHALI iOR7MMATH COMPLY WiTH 7HOSE GROY1510N5. �SSUANCE L p DATE: ��,���APPIICANT: SMIP . -� �ENERGYP/C. WARNING:FAILURE TO SE W RE WOHNERS'COMPENSATION COVERAGE IS UNUWFUL.M10 SHALL BE � � SVaIECTANEMPLOYER70CRIMWALPENALTIESANDCIVILFINE3UPTOONENUNOHED7MW5AND ENERGYPERMIT I DOLURS IS�oo,0ao1,��DITION TO THE COST OF COMPENSAipN.DMUCES AS PROVK7ED FOR IN � SECTION770lOFTHEIABORCOOE.NTEREST,AN�ATfOPNEYSiEES. .- "--- -�"-•� q�ENT1ONFEE:� � - � �� � - � � - �-� � . a CONSTRUCTION LENOING AGENCY PRE-ALT FEE: � �� �� � - � ' � O . .. - - - - - �--- . � . � � IHEPEBYA�FIRMUhDERVENALTYOFPENURYTM�7TMERE�SACONSTRULTIONLENDIN�AGENCY FOR TME PERFORMMlCE OF THE WORK FOR WNIGN THIS PEN.��T IS ISSUED(SEC.30Y7,CIV.C.�. �. . � ._ . . . . ._ �.. .. -.. , . .. . ._ ._ .. . .. _ . ._ .... . ... . W � LENDER5NAAIE � ' - ' � LENDER'SAODRE55 � ' 1 w ICERTIFYTHATIHAVEPEADTHISAPPLICATIONANDSTA7E7HATT/1EABOVEWFORMATIONISCORREGL TOTAL FEES _ _ ' - � ' _ � IAGREEiOCOMPLYVATHALLGTYANOCOUNTVOFDINMlCE5�N�5TATEUWSREUTNlCTOBNLDING . � CONSTRUCTION.ANDHEREB�AUTHOFIIEREPRESEMATIVESOFTHISCOUNTYTOENiENUPONTHE . : Z ABOVE�MENTKWEDPROPERTYFORINSPECTpNP POSES. _ ._ COMMENTS n, � I o l�. `U� �' �L��-(—fi�-� m � PERMITfEE NM1E(PH�N� , � �� .' ___... . . . .. .. • . I � SICNATUftE OF PER EE DAT '' '' � RECPT.NO. PAID 6Y �� VALIDATION , - -- - ---- - � WHITE-0epartmenl Copy.VELLOW—Finance Copy.PINK—ASsessorCopy.GOLDENROD—File Copy,GREEN—Appiicant's Copy _ . . .. . . . , , .. . .. • . s .. � � � , CIT�Y OF�DIAMOND BAR�. ' , , +, _ . ,, '� .,, t . � � �, , . . � ., . , _.. � ,,. , . . . . . . � I INSPECTION RECORD " ': ' , . , � � • • � � • • - � • � � • - SET BACK,-. '� FLOOR JOIST - - - _ FfGSlFORMS/STEEL _-____': ' -- � - � FHA REQMTS ' �,r� r ._ � � ,, ,, ELECTRIC GROUND - - UNDER FLC�OR'DUCTti.`> �'`, �i�,f�,��,..1 `'�'-:v 5' ' - GROUNO PLUMBING � UNDER`FLOOR COI�IOUIT�'L��'. �.�;' • �='. ��.t :� SLAB GRADE - ' --- • FIREPLAC�FOUNDATION— ' ._ _ v � TEMP POWER--- --_- _ --- -- - -� - FIREPLACE BOND.BEAM`��'.' .1 `'�. = _✓1 . . . WATER SERVICE - -- - '` ' MID HT�OND�EAM' . ,ti:' _c�• ' '' ' " ' ' '� ROOF SHEATHING . . _ 8 Fr.BOND BEAM � � FRAMINGNENTILIATION . = : FINAL'BOND BEAM - � ... � , ROOF COVER -- - -- --- -. --- - - PRE-GRADING ' ROUGH HEATING `"'=-'- ' - � '- BENCHING - _ ROUGH ELECTRIC ; -- - -- - " - - ' - ROUGH GRADING , , ROUGH PLUMBING - - � � - . FINISH'GRADING SHOWER/TUB TEST -�� - ��� -- POOL ELECTRIC , EXL LATH/SIDING POOL FENCING WALL INSULATION I POOL:FINAL � CEILING INSULATION � . OFF SITE IMPS. , DRYWALI.NAILING _; DEDICATIONS � ; SEWER __ ..--. ------ . : . FINAI:ENG. SEPTIC TANK.._-____._____ _" • _ _ _ _ __ LANDSCAPE/1RRIG. ., SEEP PIT/L.L.-; - - - �_. . :. ..'._ . _ON SITE IMPS. GAS AIR 7EST - - - - - -- --- -- -_-- FINAL ZONING " � FINAL CONST: --- --- - -�--- - --, FIRE DEPT.FINAL FINAL HEATING � ` --� - - -• � - - HEALTH DEPT.FINAL - FINAL-ELECTRIC " � -=�:;�-�.�� _ n�, �� :_,-.t DEV.FEES PAID , FINAL PLUMBING / � �: � � ENERGY-� `. \ \ \ '_�` <.-_'�' _> -. _' _ � � � � . , , _ _ - - --- — - ---- - ---- • — I ' . . , COMMENTS -- ' -- - - --- -- , ., , __. __ . ___ ._- ' _" _ � � ��V _ . _. _ __ '__ . _.__ "_"_' "_ _'- -, . . ., � . , �� � '" _ _ '_' _._' __ "__ � � `-_ \\' •L. .. ,"/� '"'� �. z.J l� l� � 1 t��~ !, —_ `i`, ;'..�� _ _._. . _ . . _ _ . ., ' � . .�... .., . I' �.\� ` C1 . _ . . . _ _ .. � . , . . . — � �r--�_.C._.�� S . �� -�( - �. SEPTIC TANK SIZE - - - ' SEEP PIT/U SIZE i%^— �e � � - ---- - . . . _. t..�t...rr.,_,.,,e �, . , . "+�+�++�ow.nrs�..n � � . ' '_ .. � .. . . . . �� t�- ' _ ' _ ' _ ' _ _ _ ' - � , ;,�,�� ,-� -� ,„�.}_� ,��,f�. ,� , �`�'- -�t J 1 C-1" `'�.�J . . I , i �\��,`��\�� \�''-..—''�r:",� ,. � .. . . . , , i i . .. . � � " .